Table 1.

Ways of Knowing and Seeking Medical Knowledge

Inner RealityOuter Reality
Individual Quadrant 1 Quadrant 4
Type of knowledge“I” knowledge“It” knowledge
WhyUnderstanding the clinician is essential to family practice, since in part “the doctor is the drug”Understanding that natural phenomena and interventions to affect them comprise the biological basis of medical practices
WhatKnowledge of the clinicianDisease-specific knowledge of clinical phenomena
HowSelf-reflection, journalingObservation, epidemiology, experimentation
WhoReflective cliniciansDetached observers
WherePracticePeople or parts of people
Collective Quadrant 2 Quadrant 3
Type of knowledge“We” knowledge“It” knowledge
WhyThe voices of patients, families, and communities are central to the goals and effectiveness of family practiceFamily practice operates within a systems context, which must be understood to enhance its effectiveness
WhatKnowledge of the patient in contextSystems knowledge
HowParticipatory researchHealth services research
WhoParticipant observersHealth services researchers
WhereCommunity or practiceHealth care system